Concussions, CTE and bullying have NFL fighting to change itself, but is the end near?

Woe is the NFL? Not yet. Not by a longshot. Last Sunday night, while the Saints were destroying the Cowboys in a numbingly one-sided contest, NBC drew a week-leading 21 million viewers to the broadcast. The game attracted almost 60% more viewers among the coveted 18-49 age group than the second-place finisher, the "Big Bang Theory," a show that has nothing to do with late hits on the quarterback.

"NCIS"? the CMA Awards? "Dancing with the Stars"? They were as outclassed as the Cowboys, according to the Neilsen ratings, which are at their highest for the league in seven seasons.

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So this is not about the NFL going through tough times on television or on the ledger sheets, where the $9 billion industry continues to print money as fast as it manufactures throwback jerseys. This is about more subtle things — like image-making, kids' participation, no-shows in the stands and, yes, the unforeseeable future of a very American game in a global athletic stadium.

All in all, it must be said, those things are not going so well for commissioner Roger Goodell. When the games are done and the NFL cedes control of content, the reports flashing across the screen recently are far from family-friendly.

An accused bully named Richie Incognito, whose sheer size and social indifference are enough to scare any parent, stands defiant. A superstar, Brett Favre, speaks out about his own brain damage. There is the news of two more high school football deaths, one in Arizona the other in Missouri. A male fan punches a female fan in the face outside MetLife Stadium, replayed over and over. More than 25 players are suspended in 2013 for substance abuse violations — even before proposed HGH testing takes hold. Tony Dorsett talks openly about his dire problems with chronic traumatic encephalopathy, the same brain disease that led Junior Seau to suicide, according to findings this year by the National Institutes of Health.

On it goes, this recent parade of symptoms and consequences born from our country's most popular, most macho league and sport. And while outsized television ratings remain utterly unaffected by this ugly stuff for now, the NFL must stop to wonder: What happens if the fans stop paying to attend games and if America's kids stop playing this very American sport? What happens if tackle football becomes boxing, and only the poorest, most desperate minorities risk their bodies and minds to participate? What happens if they all play soccer and basketball instead? Will families keep coming to the stadium if too many players are carted off the field, and too many fans get punched in the face?

Cowboys great Tony Dorsett is diagnosed with having symptoms of the brain disease CTE. (Rick Stewart/Getty Images)

"It's death by a thousand cuts," said David Johnson, CEO of the Georgia-based Strategic Vision, a public relations and branding agency. "Right now, it's still a family-friendly sport that escaped a lot of the scandals we've seen in baseball. But with the bullying and hearing more about concussions, with all this stuff coming, it creates a narrative. People have more means to find out about it with 24/7 news cycles. Parents wonder who's running the show. That can hurt the whole dynamic."

There is evidence of such erosion at the very foundation of the league.

Ten NFL teams are playing to stadiums that are less than 95% filled, double the number from seven years ago. Despite the Jets' surprisingly successful season, nearly 7% of their ticket-holders are not showing up for games. The NFL last year reduced its TV blackout threshold to 85% of prime tickets sold, an indication of the downward drift. Again, this is all relative. Other leagues would kill for these attendance numbers. But the arrow is pointing in the wrong direction, and arrows are important.

An HBO "Real Sports"/Marist Poll reported that 13% of parents now say they will not allow their kids to play tackle football, while about a third are "less likely" to permit such participation than they were before news of all the head injuries came to light. ESPN's "Outside the Lines" found that Pop Warner participation dropped nearly 10%, by 23,612 players nationwide, from 2010 to 2012. USA Football reported a 7% drop in participation for 2011.

Whether this exodus represents an unjustified panic reaction or a reasoned response, NFL officials are well-aware of the problem and have taken their soapbox on the road. Last month, Goodell and his wife, Jane Skinner, a former Fox News anchor, took part in a league-sponsored education and spin campaign, Heads Up Football, to convince 200 mothers at the Chicago Bears' training site that their sons should play the sport.

San Diego Chargers linebacker Junior Seau's suicide shocks the football world last year. (DENIS POROY/AP)

The pitch that day, and all days, is that football is no riskier than many other contact sports, when kids keep their heads up and don't clash helmets.

"The fact that 85% of their parents say, 'Yes we would let our kids play football,' is an indication that they want the right information and they're seeing the things that we're doing in our programs," Skinner told the moms about that Marist poll. "You may feel alone, but there are other people that agree with you."

If football participation continues to slacken, the NFL may yet survive on a purely spectator level. Gourmands don't always want to know how that steak reached their plate. Most fans feel likewise. They are enthralled with the touchdown passes, and wish to know as little as possible about the bandages in the locker rooms. But with the flood of news sources and reports, blissful ignorance is becoming harder to attain. There may come a tipping point when women bail from the stadiums and competitive participation becomes more regional.

"There's no evidence of that, but we don't take anything for granted," said NFL spokesman Greg Aiello. "There are still millions playing tag and flag football. We have great numbers in California and Texas. We closely monitor the numbers."

Aiello talks about progress made by the league in terms of tighter helmet-to-helmet rules and a change in attitudes about cheap shots. After settling a concussion-related lawsuit with former players for $765 million, there is plenty of incentive to do the right thing. Still, there are too many injuries — at least 10 teams are now without their starting quarterbacks — and considerable old-school resistance. Hardly a single broadcast goes by when some sneering analyst comments on a personal foul, "I know they're trying to protect receivers, but you've got to let these guys play football."

Seven high school teenagers have died playing football since August, including 16-year-old Damon Janes from Brocton, N.Y., a running back who died after receiving a blow to the head in a game on Sept. 13. That obviously represents a very small percentage of participating athletes, but the odds are higher than some parents will tolerate.

Football is not the only sport that fosters head injuries, of course. At the professional level, concussions have sabotaged Sidney Crosby in hockey and Briana Scurry in women's soccer. Yet football still leads the way among high school athletes when it comes to documented head trauma. According to a 2011 study in the American Journal of Sports Medicine, high school football players suffered a rate of 76.8 concussions per 100,000 athletic exposures in the sport. By comparison, boys' ice hockey posted a rate of 61.9; girls' soccer, 33.0; boys' soccer was at 19.2 - a rate exactly one-quarter as high as its football counterpart.

A recent poll sponsored by ESPN found that pro soccer is now the second-most popular spectator sport for fans aged 12 through 24, behind only the NFL. Its television ratings are dwarfed by the football league, however. MLS games averaged a paltry 220,000 viewers this season on ESPN and about half that number on NBCSN. By comparison, NCAA football, a showcase feeder for the NFL, generates ratings typically 10 times greater.

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It is important to remember, though, that sea-change shifts in spectator preferences can be slow, almost imperceptible at first. Sixty years ago, baseball, boxing and horse racing were the only three sports that some sports columnists bothered to cover. Two of them are now on life support, and baseball is struggling.

"If you look at Goodell's statements (on concussions) back in 2009 before Congress , he talked about changing the culture," said Richard Torrenzano, CEO of the Torrenzano Group in New York, which specializes in building and protecting corporate reputations. "This is 2014, so you have to ask yourself the question 'what happened in five years?' The concussion issues would scare any parent. The Incognito news would be on top of the minds of many parents because of digital bullying.

"If they don't clean this mess up quickly, it'll have a significant impact on sponsors and others around the sport, more congressional hearings," Torrenzano said.

Even the NFL isn't indestructible, once the protection starts breaking down.